Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Gladstein, MD

Individual provider Dermatology Physician · NPI 1104848811

Michael Gladstein, MD is a Dermatology in Lake Ronkonkoma, New York. Graduated from New York University School of Medicine in 1979, 47 years ago. Practices with Ji Medical PC, a 6-clinician group and works from 2 locations. Licensed in New York.

Years since qualifying
47
Trained at
New York University School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324
Phone: (631) 737-0100
Fax: (631) 417-1117
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2792 Ocean Ave Fl 2, Brooklyn, NY 11229-4731 — (833) 635-2566

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 143678 (NY)

Record details

NPI number1104848811
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 24, 2006
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 1979 (47 years in practice)
Group practice Ji Medical Pc — 6 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare